Robert Frank Tipton Jr., PARA PROFESSIONAL

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

RC1804-1804 Issued in OK

Practice address

618 E Canadian Ave
Vinita, OK 74301-3810

Phone

(918) 256-3424

NPI assigned

Nov 6, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Santa Fe Residential Care Home

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vinita, OK
  • NPI 1114351541
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1083215867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 148",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743010148",
            "telephone_number": "918-244-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 E CANADIAN AVE",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743013810",
            "telephone_number": "918-256-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPTON",
        "first_name": "ROBERT",
        "middle_name": "FRANK",
        "name_suffix": "Jr.",
        "credential": "PARA PROFESSIONAL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "OK",
            "license": "RC1804-1804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grant Thomas Thiessen
• April Thomas
• Cassidy Thompson
• Jeannett Thompson
• Nancy Thompson, LPC
• Randi Lyn Todd, PARA PROFESSIONAL
• Cindy Tonihka
• Gara Tramel, APRN
• Transcendence, LLC
• Tayler Tryon

• Assisted Living Facility (Mental Illness) in Vinita, OK
• Providers in Vinita, OK by specialty
• Assisted Living Facility (Mental Illness) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.